Patterns of tobacco use in low and middle income countries by tobacco product and sociodemographic characteristics: nationally representative survey data from 82 countries
Date
2022-07-01
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Journal ISSN
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Abstract
Objectives
To determine the prevalence and frequency of using
any tobacco product and each of a detailed set of
tobacco products, how tobacco use and frequency of
use vary across countries, world regions, and World
Bank country income groups, and the socioeconomic
and demographic gradients of tobacco use and use
frequency within countries.
Design
Secondary analysis of nationally representative, crosssectional, household survey data from 82 low and
middle income countries collected between 1 January
2015 and 31 December 2020.
Setting
Population based survey data.
Participants
1231068 individuals aged 15 years and older.
Main outcome measures
Self-reported current smoking, current daily smoking,
current smokeless tobacco use, current daily
smokeless tobacco use, pack years, and current
use and use frequencies of each tobacco product.
Products were any type of cigarette, manufactured
cigarette, hand rolled cigarette, water pipe, cigar, oral
snuff, nasal snuff, chewing tobacco, and betel nut
(with and without tobacco).
Results
The smoking prevalence in the study sample was
16.5% (95% confidence interval 16.1% to 16.9%) and
ranged from 1.1% (0.9% to 1.3%) in Ghana to 50.6%
(45.2% to 56.1%) in Kiribati. The user prevalence of
smokeless tobacco was 7.7% (7.5% to 8.0%) and
prevalence was highest in Papua New Guinea (daily
user prevalence of 65.4% (63.3% to 67.5%)). Although
variation was wide between countries and by tobacco
product, for many low and middle income countries, the
highest prevalence and cigarette smoking frequency
was reported in men, those with lower education, less
household wealth, living in rural areas, and higher age.
Co nclusions
Both smoked and smokeless tobacco use and
frequency of use vary widely across tobacco products
in low and middle income countries. This study can
inform the design and targeting of efforts to reduce
tobacco use in low and middle income countries and
serve as a benchmark for monitoring progress towards
national and international goals.